Category Archives: Uncategorised

TeamHaem saves Christmas 🎄- Part 3

‘Has anything changed since this time last year? Any illnesses or weight loss? Tell me all, do not fear!’   Coyly he blushed as red as his suit ‘I’m afraid the answer is hidden by my boot’   Mrs Claus … Continue reading

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TeamHaem saves Christmas 🎄- Part 2

His eyes twinkled like stars, his sats 92, “You must let me home I have work to do!”   I have no time to lounge around here, Who is going to train and feed the reindeer?”   “Do you fly … Continue reading

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Team Haem saves Christmas 🎄 – Part 1

Twas the week before Christmas and all through the lab not an analyser was stirring, ten winks I did grab.   When then from my call phone there arose such a clatter, I sprang from my bench to see what … Continue reading

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Case 103 – summary

Thankyou for your help with this week’s case! Our patient has an intravascular transfusion reaction which was likely due anti C with undetectable antibodies. Red cell phenotyping of the patient and the transfused red cells help identify the likely antibody. … Continue reading

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Case 103 – update 2

We think our patient may have had an intravascular haemolytic transfusion reaction, although our negative investigations so far are unusual. The patient’s Hb is now around 55g/l. The creatinine is now around 500umol/l. Bilirubin is now 20 and haemoglobinuria resolves … Continue reading

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Case 103 – update 1

We have found out that our patient has just started adjuvant chemotherapy for breast cancer following surgery. Five days prior to admission she had a 2 unit blood transfusion, which had no immediate complications. She had no transfusions prior to … Continue reading

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Case 103 – the beginning

Welcome to this week’s teamhaem case! This week we start with a 50 year old lady who has presented to A&E complaining of feeling tired and she has, over the previous couple of days, noticed blood in her urine, however … Continue reading

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Case 102 – The Summary

  Thank you for all the contributions to the case this week! This week we discussed a 29 year old lady who presented with an extensive left arm DVT. She had been on the COCP for 2 years. Further investigations … Continue reading

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Case 102 – Update 3.

We now have further results for our 29 year old female who presented with an extensive left arm DVT and SOB. She was commenced on therapeutic LMWH. This thrombosis was provoked as she has been found to have a 11cm … Continue reading

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Case 102 – Update 2.

Thanks for everyone’s contributions! We have been discussing the management of a predominantly idiopathic upper limb DVT in our young lady on the combined OCP. She is on therapeutic LMWH and currently continues on the combined OCP. However, your requested … Continue reading

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Case 102 – Update 1.

Thanks for everyones contributions! Following everyone’s suggestions we now know that this 29 year old with an extensive upper limb DVT, has been short of breath over the past few weeks and non-specifically unwell. She has been on the combined … Continue reading

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Case 102 – The Beginning

Welcome to the new #TeamHaem Case! You are working in the acute medical day unit. A 29 year old female has been referred in with a week long history of progressive left arm swelling. An ultrasound has confirmed an extensive … Continue reading

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Case 101 – summary

This is a case of super warfarin overdose. It was complicated by the lack of accurate history from the patient due to presentation with an intra cranial haemorrhage. Super warfarin are easily available as rodenticides. The most common in the … Continue reading

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Case 101 – update 3

Further history is sort and her partner confirms the presence of rat poison in the house. Repeat factor levels show: Factor II – 24%                         Factor VII – 9% Factor … Continue reading

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Case 101 – update 2

She is treated for vitamin K deficiency and prescribed 10mg vitamin K IV for a further 2 days. 36 hours after admission you are called because she had developed epistaxis and frank haematuria. Repeat bloods show: Hb 89  g/l MCV … Continue reading

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Case 101 – update 1

She is given prothrombin complex concentrate and vitamin K 10mg IV. She has a history of asthma and depression, she has taken sertraline for the last five weeks and salbutamol inhalers infrequently.  There is no history of anticoagulant use and … Continue reading

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Case 101 – the beginning

Welcome to the new #TeamHaem Case! You are a medical doctor working in a busy emergency department. You are called to review a 34 year old woman who has been brought in by ambulance.  She was found by her partner … Continue reading

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Case 94 – update 1

Our patient has undergone emergency surgical decompression for severe C3/4 spinal cord compression secondary to a lesion in his C3 vertebral body. He is recovering well on the neurosurgical ward. Initial investigations were unremarkable. Results update: Following discussion, the further … Continue reading

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Case 94 – the beginning

Welcome to our new #TeamHaem case! You are the junior doctor in A+E. The next patient to be seen is a 38 year old man who has presented with severe neck pain. He works as a builder and has been … Continue reading

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Case 89 – update 2

Thank you for everyone’s contributions so far! Update of investigation results as requested: Bone marrow trephine: myelofibrosis. BM cytogenetics: monosomy 7 Peripheral blood: JAK2 positive. No circulating blasts identified on blood film. USS abdo: 16cm spleen (Hb 95, Plts 90, … Continue reading

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